Posts Tagged ‘frustration’

So if I can now be considered “stable”, why has so little changed over the last few months? I know it is good that I am generally feeling a lot better, but I’m getting a bit fed up of this “stability” to be honest. It seems that I am still unable to return to normality and start living my life again. I am still stuck in the limbo I’ve been describing for months now and it is getting tiresome.

I know this feeling mainly comes from the fact I am still not back at work. Before I was ill, I pretty much defined myself by my work. I was probably a workaholic and I really enjoyed my job, so to stop working was a massive adjustment and disappointment. When I was first signed off I never imagined I would have been off this long. It has been over two years now.

On Thursday I returned to Dr Occy Health (I can’t remember what I referred to him as last time). I was disappointed that the outcome was little different to last time. I had gone in there hoping that I would have some goals to work to and a rough schedule planned for my return – 1 afternoon a week, 2 afternoons a week, 2 days etc. It soon became clear that he had nothing like that in mind and if anything he still didn’t expect me to be going back at all.

We talked about how I’d been, my job and what barriers there were for me returning to work. Unfortunately there are quite a few barriers. He seemed concerned about the number of unknowns involved. As I have mentioned plenty of times, I work in consultancy. This means that things are unpredictable because everything is dependent on client demand. It is what appealed about the job, but it also makes it difficult to plan ahead. I can’t just resume my old job on reduced hours and responsibilities because my old job doesn’t exist any more. I have to find myself a role, which is going to be difficult especially as I won’t know when I will be ready to start and roles are coming up and being filled all the time. I will be of no use to a client if I’m only in for a couple hours a week anyway, so I don’t know what opportunities there are for me.

There is also the problem that I am based in Manchester and all the support network and internal work is very much London-centric. The Manchester office is simply a regional base where people drop in for meetings, to get their laptops fixed or to perhaps spend a day working away from the client, but no-one really works there on a permanent basis. Everyone is based on a client site at least 95% of the time. We have no HR staff up here, my career counsellor is based in London and I have no manager to report to. I will essentially be on my own. Dr Occy Health does not like this very much and I think he wants some face-to-face support to be put in place before I try to go back.

I told him I was keen to do something to get back soon though. He wouldn’t let me make any firm plans to return and he did not want to give my employer any idea when I may be back as he wasn’t happy about committing me to anything. During the appointment he started to draft his report for my employer and he was quite clear about not setting any deadlines for my return.

One thing that worried me was the way he always talks about “if I return”. I don’t what to think that I may never go back. He seems to be pretty careful about not raising my expectations, which I guess is probably a good thing, but it also knocks my confidence. If he is so worried about how I cope, does that mean I won’t be able to? He is clearly very concerned and I find that a little disconcerting. I know the likelihood of anyone returning after such a long absence is pretty slim, but surely I can be one of the minority?

I think he may be worried, not only about what pressure I put on myself, but also how things may end up with my employer. They may be well meaning and understanding in theory, but the demands of the business are such that I can see it being very easy for me to fall into the trap of taking on too much, too soon. I think once I am back in that environment the competitive nature of the place is likely to put pressure on me. I recognise that and maybe that acknowledgement will be enough to prevent these problems, but I am not entirely sure it will.

He asked me what I wanted in life. Not just with my career, but my entire future. I told him that I honestly don’t know. I told him that I spent so much of the past two years not expecting or wanting to have a future, that I find it hard to comprehend. He said this was sad and I guess it is, but it is just the way that things were. I don’t know how things are going to turn out. I don’t trust myself not to relapse. I am still kinda expecting everything to just fall apart again and I worry about getting my hopes up about anything. Being relatively well and stable is not something I am used to any more. I am genuinely scared about what the future holds and I don’t know where to start.

I think he asked me about the future, because he really wants me to consider another career. He seems to think that returning to the same company isn’t wise, but I’ve thought about this before and I am not sure I can see myself anywhere else, anytime soon. Dr M definitely thinks the same too. Whenever I talk about my work and my company she expresses her concern and in particular, her distaste for the competitive nature of the place. There seems to be an expectation that because I have been mentally ill, I should just get a nice, easy, repetitive job that doesn’t involve any stress or pressure. I really don’t like this.

Even if I did want to reconsider my career, I don’t feel I have any other option. I feel almost a sense of duty to return to my employer after all they have done to support me whilst I’ve been ill. I hope that they will do what they can to maintain that support and to keep me in work, but I do have my doubts.

No employer in their right mind would take me on now with this absence behind me either, so what choice do I have? I am concerned enough about how I will find roles within my current company, let alone finding a whole new employer. What manager is going to want to trust me with a client if I’m likely to have another meltdown and take two years leave at no notice?! It is a big risk for anyone to take on and I completely understand that. If they’re offered me or any other one of my 250 peers, it would be stupid of them to choose me. DDA or no DDA, that is a fact. They are a better fit for the job, because they are less of a risk and minimising risk is a massive part of our job. I know there is a point when that risk will become minimal. If I manage to get through the initial stress and pressure of a return and stay well, then there is a good chance I can maintain that, but there is the difficult bit beforehand to negotiate. It’s a bit of a catch 22, because I will need a role and responsibility in order to gain the trust and confidence of future managers, but getting that first role without a proven track record is going to be pretty hard.

So what other options would there be? A life on incapacity? No thanks. I doubt that option will be open to me for much longer either – I doubt I’d pass a medical now, even if I am still deemed unfit for work by occupational health. The WCA for ESA is notoriously bad at turning down seriously ill people, I still find it hard to believe I got through it the first time.

Anyway, we went on to talk about what I can do now. He said the primary objective needs to be starting some contact with work and working out how I can start to “reconnect with the workplace”, but there is no way I should take on any responsibility any time soon.

He set me the “homework” of looking for opportunities and ideas for ways in which I could start to make contact with work. He didn’t seem to expect me to actually carry any of those out, although he said if I felt up to it I could perhaps make a start. It was suggested that when I was ready, I could perhaps try visiting the office for an hour or two to see how I feel about it. Maybe I could shadow someone for an afternoon, just to remind myself of the kind of work that we do. Maybe there is some training I can get involved with. Maybe I could just meet up with someone to talk through some ideas. These are all possibilities in theory, but whether or not any of them will happen is another matter. I remember talking about these sorts of things with Dr R, the previous Dr Occy Health and although I brought them up with HR, there seemed to be a reluctance on their part and nothing really came of them.

I contacted my HR rep after the appointment anyway to see what she thought of the suggestions, but she said she’d like to wait for the report to arrive before discussing anything. My copy of the report arrived this morning, so hopefully she will be in touch soon. I also just found out that she’s pregnant and going on maternity in a couple of weeks and I don’t know who will be taking over. I guess it probably doesn’t make much difference as they will be based in London anyway, but the latest HR rep has been pretty good and some consistency would probably be helpful when I am trying to go back.

Anyway, we will have to see what happens. The plan is to review things in a couple of months. I hope that I will be able to try some of the suggestions before then, but whether or not they will let me is another matter.

There is a breakfast meeting of the office forum in a few weeks time and they have kept my place on the committee open whilst I’ve been off. I’d quite like to go along and there should be no pressure, so maybe I will be able to go to that.

I still feel a lot of guilt about not working and aside from Dr Occy Health, I think everyone is expecting me to get back to work now. If I’m relatively well, generally coping on a day to day basis and even capable of going travelling for a couple of weeks, there should be no reason why I can’t go back to work, right? Sadly not. I guess it is different. There is no pressure on me at the moment. I can do as much or little as I feel like and I don’t have to worry too much about making mistakes or breaking commitments. I can’t carry on like this forever though. I am going to have to test myself eventually.

I also still worry about the benefits side of things. I don’t want to be on ESA any longer. You hear all the time at the moment about how people are stuck in the cycle of claiming benefits and how we should all just get back to work. I wish they realised just how hard it was, even for those that genuinely want to go to work, have a job to go to and are even feeling ready enough to try. There are so many barriers to overcome and the things at stake are too much if things don’t work out. I guess I just have to be patient. I will get back eventually.

Anyway. This post is long enough. I’ve said so much of this before, which is partly why it is so frustrating. I just feel like I’m not getting anywhere. I suspect I will be writing about work a lot over the next few months. Hopefully there will be some progress soon.

p.s. I also want to write about my therapy assessment – but I don’t have the time now. That was also pretty frustrating and disappointing, but I will try and explain soon.

I’ve had a lot of good days lately. My mood has picked up sufficiently that I am feeling almost “normal” at times now and certainly manageable at others. I have actually felt happiness or contentedness, something I wasn’t really sure was possible any more. My concentration has been improving and my confidence is growing.

I have started to contemplate the idea that I may finally be heading towards some form of recovery. Maybe, just maybe, we have found the drug that works, despite the problematic side effects.

I have been foolish though in thinking the bad days had passed. I had hoped that I wouldn’t feel that bad again, at least any time soon. I really didn’t feel good yesterday. I woke up feeling low and felt worse as the morning went on. For the first time in a while I felt seriously suicidal, as opposed to the passing thoughts that had been floating around, but which I could brush off relatively easily. I was having to really fight the urge to just thrown in the towel. I felt anxious and uneasy. I’ve been struggling with strange dreams and nightmares lately and they were bothering me. Everything just felt wrong somehow. I wanted to crawl back in to bed and hide there. It felt like nothing had changed. I thought I was past all that, but I was wrong.

Things did start to improve again yesterday evening, but I am feeling a little shaky still. I feel like I’ve been knocked off balance and I’m struggling to right myself.

I am trying to tell myself that this is normal, recovery isn’t a smooth process and bad days are to be expected, but it doesn’t ease the disappointment. Telling myself this didn’t make yesterday any easier.

I hope that things will pick up again, but I am worried that this will set me back. One of the things I struggle most with is the idea that I will never be completely well again and there is always a fear of relapse. A bad day is like a mini relapse and it makes me question if it is all worth it. What is the point in carrying on, if in 6 months, a year, 20 years I end up severely depressed again and try to kill myself? My thinking may be screwed up, but I just wonder if I may as well get it over with.

I had been thinking about going back to work. I do miss it and I’ve been missing it even more when I’ve felt okay. I wonder why I am not there. I know I have only just seen Occy Health and I agree that I’m probably not ready to go back just yet, but I was starting to think that I will be able to do it. Even 3 or 4 weeks ago when I was there, I doubted it would ever be possible. A run of good days has made me think it is, but this bad one has put the doubt back. I worry that it would only take a couple of bad days at work and I would be back where I was before.

I’m still really struggling with the future. I panic when I think about what lies ahead. I am scared of therapy. I am scared of going back to work. I am scared that I will relapse. I am scared of commitment in all shapes and forms. I am scared of getting married. I am scared of buying a house. I am scared of getting old.

I am frustrated, because I was meant to be seeing Dr M on Thursday and I got a phone call today to say she has cancelled. I am disappointed, as after yesterday I felt I could really do with seeing her again soon. I wanted to discuss the Reboxetine. I think it is time to increase it to the “therapeutic dose” (4mg b.d.). I hope that those extra 2mgs will be enough to stave off the bad days. I just hope it isn’t enough to tip the side effects into not-worth-it territory. She was also going to discuss what we can do to ease the side effects, particularly looking at sleep again – the insomnia is the biggest problem. I quite wanted to know what ideas she had come up with since I’d last seen her.

I now have to wait another 2 weeks. It is going to end up being 6 weeks between appointments by the time I eventually see her and we were aiming for every 2-3 weeks, so that’s not so good. It may still be better than the CMHT, but I could have done with seeing her sooner.

I guess I will just have to manage how I am. We will see what happens. I’d like some more good days.

My last post, Distressing Diagnosis… was a little on the rushed side and basically unfinished when I posted it. I knew if I didn’t publish it when I did, I wouldn’t get the chance for a while, but I kinda wish I’d held back. I’ve been back and edited it a little, but it still doesn’t say everything.

Edit: (17/03/2010) – I’ve actually ended up reworking this post quite a lot too. I didn’t read it back yesterday and since then I’ve realised it was all over the place and made little sense. It is a little better, but I just find this so hard to write about objectively. I am struggling with it all.

Lets get one thing straight. Dr M isn’t a horrible person or a bully. In many ways she’s actually quite nice and well meaning. She is trying hard to help. I can see that and I appreciate it.

She said she doesn’t want to do anything that will make me worse, and she did agree to remove the diagnosis in my notes when I said it wasn’t helping. I guess I can’t really argue with that. I asked her to change her diagnosis and she agreed to do so. I don’t think she’s changed it in her mind, even if she has on paper, but that is at least something.

She genuinely thinks she is helping and that she is doing the right thing. She keeps saying that she will make me better and that the future is hopeful. She is always very positive and encouraging. Many patients probably really appreciate this approach, but I find it a little too much. I don’t see enough evidence to support her positivity and that can actually be damaging. It makes me lose faith and trust. I find that she can ignore the negative, which means I don’t feel like I am being listened to or taken seriously. Unfortunately she doesn’t seem able to recognise this or she is unwilling to adjust her approach.

She also gives me her time – lots of it. She tries not to rush her appointments and lets them take as long as they need to, even if that means she runs behind fairly often. One of my ward rounds was over 90 minutes long, which when I realised seems pretty incredible. She saw me regularly on the ward in addition to the weekly ward rounds. She is now seeing me fortnightly as an outpatient, as opposed to the huge expanses of time between each CMHT appointment (4 months!). This is a good thing. It is closer to what I was used to in The Priory and a vast improvement on my other NHS experiences. Usually they sit you down and before you know it the appointment is over and nothing seems to have happened.

There are certainly good points to her care so far. I think it probably is an improvement on my other experiences with the NHS, but there are issues and I am finding those hard to deal with. Overall though I don’t think she’s a bad psychiatrist. I am just not sure she is the right doctor for me and I am not sure I am the right patient for her. Things just don’t seem to be working.

I don’t think it helps that we just don’t seem to get on. She was not impressed with my initial request to not be patronised and I think that clouded her opinion of me right from the start. She doesn’t seem to understand my job and why I like it. She doesn’t seem to know how to deal with me questioning her. I have a real sense that she just doesn’t like me for some reason. There was one point that she pretty much said that she couldn’t get on with me in “real life”, although I can’t remember the context now. My bloke tells me that is paranoia, but I remember it because I was shocked at the lack of professionalism and was upset that she didn’t like me.

I know I can’t hold this against her though. People don’t get on with each other and that’s a fact of life. If she doesn’t like me then fair enough. I’m not sure I’d get on with her in “real life” either. It wouldn’t matter though if it didn’t affect our therapeutic relationship. I worry that part of the reason she has diagnosed NPD purely stems from a sense that she doesn’t like me. Is it because she thinks I’m arrogant because I didn’t want to be patronised? Is it because I don’t agree with her opinion? I fear that in many ways it probably is.

It’s always going to be easier to trust and work with someone you get on with and I am finding this hard. It was one of the things I found great about working with Dr G. We got on well and could talk about anything, not just my treatment. It felt a lot more therapeutic and less clinical, which I think is important when dealing with mental illness, which is so entwined with emotion. I miss the way things were with Dr G and I am not used to the change. I don’t see the relationship with Dr M ever being like that. I find it hard to talk to her and hard to trust her. I am meant to tell her how I feel, yet I don’t feel comfortable doing so.

I also struggle with the fact that she doesn’t seem used to dealing with patients who are capable of getting dressed, eating and general functioning. Even if you had just tried to kill yourself, said you felt absolutely terrible and were threatening to do yourself in, if you could get up and about, communicate, eat and drink etc. then you are not really depressed and should be discharged. There seemed to be little acknowledgement of the fact that patients hide how they are feeling and put on a mask. There was a lot of focus on the functional side of depression and little acknowledgement of the emotional side and how patients felt. I wasn’t the only person who noticed this. A few of the more functioning patients felt that they were always being pushed to go home, treated as if they weren’t really ill and made to feel like they were a fraud. One patient was discharged too early a couple of times because she always hid how she felt and seemed “well” but she ended up back in hospital within days. You would have thought they would realise this was a problem. I don’t think this is purely down to Dr M. There were unbelievable bed pressures and the nurses weren’t exactly great at observation, but at the end of the day she makes the decision to discharge.

I wondered if this was because she is used to treating patients who aren’t functioning – those who are catatonic, staying in bed, barely speaking etc. In many ways these patients probably are more severely depressed, but that doesn’t mean they are more “worthy” of being in hospital. Non-functioning patients are a lower risk because they aren’t even capable of hurting themselves, where as a functional patient who is dealing with distressing thoughts needs to be kept safe. There didn’t seem to be much acknowledgement of this. I always felt like I was being told my problems weren’t important and that it didn’t matter how I felt.

Maybe Dr M has a problem working with me and other patients in a similar situation because she just finds it easier to deal with patients that do as they are told and don’t answer back. I guess anyone would find it easier to deal with people that follow blindly and don’t question things, but it is wrong to judge those that aren’t like that. Maybe it is as simple as a power trip. She likes to be in control and feels threatened when that power balance is upset? I don’t know.

It was also a common complaint on the ward that she thinks she’s really in touch and that she knows what you are thinking, but the reality is she’s often a long way off. Sometimes you get this hint that she might actually understand and then she says something else to contradict that five minutes later. It can be quite frustrating because you get this feeling of hope that she is listening and understands and then you get disappointed. You often feel like she is jumping to conclusions or judging you and I find it hard to talk to her. I don’t have this problem with Dr N and I never had it with Dr G. They listen to you and seem to understand what you are trying to say.

I think my feelings towards the NPD diagnosis have made it hard for me to work with her. I am offended and upset by it and I associate her with this distress. It feels like a personal attack and I find that hard to deal with. I don’t want to be considered as narcissistic, arrogant, self-serving etc. I want to be a “nice” person, someone that people can trust and get on with. I read the descriptions of people with NPD and I am scared that anyone could think I was like that. I am disgusted with myself that someone can think I am the horrible person that the NPD diagnosis describes. I can’t handle my thoughts and emotions around this and I need someone to direct those frustrations at. I guess naturally I will direct them at her. As much as her views of me may be misguided, my feelings towards her are skewed because of my feelings around this.

I still don’t think the NPD diagnosis is very accurate (although I do understand to some degree why she may have diagnosed it). I certainly don’t think I meet the criteria and I think she was wrong to diagnose it in the way she did. I really question her judgement and it is going to be hard to work with that in mind.

Personality disorders seem to be her diagnosis of choice and that worries me. She seems to be giving anyone that doesn’t respond well to medication, functions “too” well or who doesn’t fit in the usual boxes, a personality disorder. There was someone on the ward who was diagnosed with Bipolar Disorder many years ago and she had seen multiple psychiatrists who agreed with that diagnosis. Dr M began treating her, quickly questioning depression and suggesting her personality was to blame for her thoughts. There seemed to be no logical reason for this, only the fact that she functioned fairly well and medication had stopped working.

I guess in many ways a PD diagnosis means the emphasis is on the patient to get better and not the doctor. If the patient doesn’t improve the psychiatrist doesn’t need to justify herself in any way. The patient is also fairly powerless because any questioning of the diagnosis could be considered a symptom of the disorder. “I’m the doctor, you’re the mental, now do as you’re told”. It probably helps that there is enough of an overlap between symptoms of a personality disorder, general life experience and other conditions that there will probably always be some evidence you can use to back up your opinion.

A little off topic perhaps, but I do still want a second opinion on the diagnosis, but I don’t know how I go about getting it. With the diagnosis lifted from my notes, I don’t know where I stand. My personality is now “under investigation”, but does that mean she is going to change the way she thinks about me? I doubt it. Do I just wait and see what happens when the therapy referral comes through or do I try and get things clarified now? Presumably there are still mentions of the narcissism on my notes, so will that influence things in future?

I wonder if I should ask about the Affective Disorders clinic in Manchester. A couple of people have suggested it to me and they have someone who focusses on “complex needs”, who may be able to comment more on the relationship between my mood disorder and any personality problems. There’s also the CUPS service in Cardiff, who has a similar service offering second opinions to anyone in the UK with complex mental health issues. The problem with these services is they require referrals from your consultant and I don’t know how to ask her, without sounding like I don’t trust her opinion.

I don’t know.

I still don’t really know what to do or think about it all. In some ways I know I should just try and forget about it now that the problem label has been rewritten, but the therapeutic relationship thing is a problem. I still have to see her every couple of weeks after all and I don’t know how things are going to work.

I guess my conclusion is though that Dr M isn’t all that evil. It’s the NPD diagnosis that’s the problem and it is going to be an elephant in the room for a while I think.

It has been a long time since I last posted. I’ve been popping onto twitter to write a few 140 character updates, but that’s all I’ve had time for. I think the amount of woe on there will suggest how things have been though.

Sadly there was plenty of backlash from the confession about my meds. I had feared it, but hoped it wouldn’t materialise. My bloke was upset. As is often the case when he’s angry, he ignored me and wouldn’t speak to me for a while and then he had a go at me. I know it is understandable that he was upset, but I get fed up of the same argument.

Apparently I don’t want to get better and my illness is all some “stupid teenage fantasy”. It seems I want to think that I’m ill so that I fit in with all my “whiny teenage girl internet friends”. He thinks that we all encourage each other to get worse and that we all want to be part of some stupid mental club. Basically, the argument always boils down to the same thing. Blogging is evil and that everyone that does so is a whiny, faking moron.

As you can imagine, this doesn’t exactly go down well. I try to argue back, but it’s pointless. I can say that I don’t choose this illness. I can say that I am definitely not trying to fit in, but that I appreciate knowing I’m not the only one going through this and the support helps. I can also say that not everyone who blogs is a teenager or a girl and that not every blog I read is about mental illness, but it makes no difference. His mind is set and he will never be happy about my blog.

As well as the argument, he tried to stop me coming on here for a while. He also banned me from meeting up with Em and Kate. We’d arranged to meet up when I had my appointment with DP before Christmas. Instead my bloke took the afternoon off work and drove me to and from the appointment so I couldn’t see them. I hate that he treats me like a child.

I find this so hard. I don’t know what I would do without this space and without the support of my readers, but I am fed up of the arguments. He makes it uncomfortable every time I try and come on here. He moans at me every time I open my laptop. He refers to twitter as “twatting”. He belittles the whole thing and doesn’t see or care how much it hurts me. I have always found the internet a great source of support and he seems hell bent on ruining that.

I’m not sure posting this is a good idea. It will probably only add fuel to the fire, especially so long after the event, but I’m still feeling the consequences. I feel guilty whenever I come on here. I feel like a naughty girl defying her parents, and it shouldn’t be like that. I wish it wasn’t.

I have other things to post about. My last appointment with DP, Christmas, the end of the year/decade… but I don’t suppose I’ll get much chance this week.

To illustrate the point, he just came over, looked at my laptop and saw I was writing. Then said “for crying out loud” and walked off. Just these little digs all the time are making it all harder.

I don’t really know what to say. I have posts I want to write about specific topics, but I don’t know where to start. Head is a bit fried really and I’m just so unbelievably exhausted.

My social worker came yesterday. I had forgotten she was coming and had a bit of a panic when my phone alarm went off. To put it bluntly, she really is full of shit. She spouted all this stuff about positive thoughts and recreating brain pathways and activating synapses, when she clearly had no idea what she was talking about. She was basically waving the CBT stick at me, but tried to dress it all up in technical language and scientific explanations. I am fed up of her suggesting that all my problems will be fixed if I just apply some CBT, think positively and buck my ideas up. I have done a lot of CBT in the past, most of which is common sense. I’ve been applying CBT methods myself most of my life, long before I even knew what CBT was. How do you think I managed to cope with the depression of my childhood, teens and university years? Things have got worse and these methods just aren’t enough any more. CBT doesn’t work for everyone. There is limited evidence to suggest that CBT works with Bipolar Disorder and severe depression (and apparently that’s what it is) anyway, but still they persist. Maybe if I just try that little bit harder it will? Maybe it’s my fault it doesn’t?

Yesterday, I also managed to cut my wrist. This was an accident involving some wire netting and our fish tank. It’s a clean cut, about two inches long, right across the top of my wrist. The blood poured and I felt this massive urge to make more. I’ve not self harmed at all for a couple of months, but it was a clear trigger. I’ve never really cut. A couple of times perhaps, but it’s not my chosen method of self harm.

When I was last self harming I don’t think I wrote about it, not wanting to alert my partner to the fact. There was a hammer lying around the house, not put back in the garage after some DIY. I was routinely hitting myself with it, all over my body. Sometimes it would bruise, but these could easily be blamed on the dog. She’s bruised me herself enough times. Other times it hurt like hell, yet didn’t leave a mark.

I can’t remember why I started again. I just felt the need one day in the summer, saw the hammer and that was it. Actually I don’t know if the hammer or the need came first. Maybe I was triggered by it then.

This seemed to help for a while. It released some frustration. Things carried on for a couple of months, but then it stopped as quickly as it started. Again I don’t know why. Soon after, we tidied the garage and the hammer went back.

Now I am struggling with the urge again. I want to hurt myself. I don’t know why. I don’t even think it would help. I just want to do it. I have resisted so far and I will keep resisting but the thought is niggling away. I wonder if I will ever get away from the temptation to hurt. I seem to stop and start without rhyme nor reason.

A couple of days ago I got a letter from the local jobcentre asking me to come in for a “Pathways to Work” interview in two weeks time. The Pathways to Work scheme is designed to get people of incapacity benefits (IB or ESA) and back into work. It is geared at people who do not have jobs and the support offered is all about work experience, improving skills and finding a job. For someone who already has a job but is just too unwell to work, this is obviously a complete waste of time.

The literature that came with the letter was even more frustrating. There were a number of “success stories” of disabled people who had successfully got into work through the Pathways to Work scheme. The disappointing thing was all of these people had got minimum wage jobs in local supermarkets, washing dishes in kitchens or working in DIY stores. There were no teachers, lawyers or accountants. No doctors, nurses or IT consultants. No one was in a managerial position. Everyone was in a basic entry-level role, with few prospects for career progression and no doubt earning very little. I know for some people, a job in a supermarket is a massive achievement, but for many it is a massive step down. Not everyone on incapacity benefit has had a poor education or learning difficulties. Some of these people are highly intelligent, highly employable and have been previously very successful until they became ill or disabled. Surely these leaflets are not providing a positive image of disability? The leaflets should be saying, “look, you’re disabled but that doesn’t mean you can’t be successful and get a great job”. Instead they seem to say, “Oh, you’re disabled so you are obviously only capable of stacking shelves in a supermarket”. It is as if disabled people aren’t worthy of aspirations and successful careers.

This poor image of disability is reinforced by the services offered. Improve your CV. Training opportunities to improve your skills and employability. Work placements and buddy schemes. Money for attending job interviews. All of these things suggest that disabled people aren’t employable and need all the help they can get to find a job. Disabled people clearly aren’t capable of thinking for themselves and writing their own CVs. It may be true that in the current climate everyone looking for a job needs help, but this all seems very patronising and demeaning.

The other impression you get from the leaflets was the familiar story that people on incapacity benefit should just pull themselves together and get to work. There was a real sense of the Government’s displeasure about people being on disability benefits. On the first page it states that Pathways to Work is a key part of the Government’s plans to get one million people off incapacity benefits by 2015. Is it really feasible that one million people will recover from their disabilities? In theory it would be great if one million people became well enough to get back into work, but to me, the answer is not Pathways to Work. The answer is improved health care; quicker access to therapy for mental health patients, shorter waiting times for knee or hip joint replacements, more research into treatment for conditions like fibromyalgia, MS and chronic fatigue syndrome. People need successful treatment and support that will help them to recover and manage their condition. Help finding a job or gaining work experience isn’t going to make them well. Yes, working can improve well being and confidence, but for many it is just not an option.

I’m really not. Everyone seems to expect me to be fixed now that I’m out of The Priory, but I’m not. I’m less okay now than I was when I was there. Now I have to cope with life on the outside, on top of all the darkness and mess that was there already. I hate it.

I haven’t written much lately, mainly because I’m not well enough to write. My family read this blog and I don’t want them to know the grizzly truth of how I really feel. I know now that by writing this, they will of course know I have been hiding things again, but I feel that it is almost bursting out of me. I just want to scream. “I’m not okay, I’m not okay, I’M NOT OKAAY!!”

I hate how trapped I feel by everyone else’s need to know that I am okay. Everyone else wanting me to be fine so that they can be okay. They don’t realise that it only makes me feel less okay. I hate how I seem to have no choice in the matter. I have to be kept safe and pretend to be okay even though it’s the last thing that I want. It just makes me more frustrated with life and two fingers to that.

I don’t know what else I can say. I don’t really want to go into the grizzlier truth. I will only be forced to talk about it and that’s the last thing I want right now. None of this is a topic for discussion. At least, not with my family. It’s all too close to home.

EDIT: Maybe I do want to write a little more. I just need to get some of this out. One of the things I am battling with is where to draw the line with honesty and openness. I know that I’m meant to be more honest with my family and doctors, but it’s hard, especially with my family. It’s made harder because the last thing they want to hear is that I want to kill myself and I don’t want them to stop me. It’s made harder because I am meant to be rebuilding the trust between me and my partner so that I can have a bit more freedom. At the moment, I am barely allowed at home alone, meds are locked away, my car keys are taken off me. The last thing he is going to do when he hears that I’m suicidal is give me more freedom. I can’t stand that. I feel suffocated. I feel like he is my keeper, not my lover.

I am trapped between how I feel and how people want me to feel. I am trapped between keeping people happy or being honest and neither is a sensible option. It all leaves me wanting to scream.